Migraine Medications for Kids

There are safe and effective treatment options that can improve your child's migraines. Symptoms of childhood migraines include headaches, vomiting, stomach aches, irritability, and fatigue. Parents and children might not always recognize the effects of a migraine, but treating these episodes at an early stage can help alleviate hours, or even days, of pain and discomfort.

After you and your child discuss the symptoms with your child's pediatrician, you can agree about what to do when a migraine occurs. If the migraines are frequent, you may need to discuss a preventative strategy as well.

Medication Options

There are a number of over-the-counter (OTC) and prescription medications used for migraine treatment and prevention. Most kids improve with OTC treatment, but sometimes, a prescription is necessary to manage the symptoms.

Over-the-Counter

If your child complains of occasional head pain, you may have tried OTC pain relievers already. These, along with anti-nausea medications, are commonly used for childhood migraines. Before giving any medication, talk to your child's doctor about what medicines and dosages are appropriate for children their age. Never assume it's safe to give your child a lower dose of your own medication.

Children's doses of OTC medications are typically based on weight. Carefully read the instructions included on the box and use any included measuring cups for liquid formulations.

There are two types of OTC medicine commonly used to treat headaches in children. These include:

• Pain relievers: Tylenol (acetaminophen) and Advil (ibuprofen) are pain relievers that come in formulations for infants and young children. Aleve (naproxen), another commonly used pain reliever, is approved for children over the age of 12. When taken as directed, these pain medications can effectively relieve migraines in children.
• Anti-nausea drugs: For children, migraines can manifest with stomach discomfort, abdominal pain, aversion to food, nausea, or vomiting. Children's Benadryl (diphenhydramine) or Dramamine (dimenhydrinate) may relieve these symptoms, as well as headaches and pain. Anti-nausea medications can be used during a migraine attack or as a short-term preventative measure if your child often gets migraines after certain triggers, such as traveling on an airplane.

Ginger may also be helpful as a treatment for migraine nausea. Try incorporating ginger chews or ginger tea into your child's diet to relieve stomach upset or nausea during or right before a migraine. Talk to your child's pediatrician for more details.

Prescription

If your child's migraines do not improve with OTC pain medications, it may be time to consider prescription options. Some prescription medications are used for the treatment of migraine episodes, while a few can be used for migraine prevention.

If your child is having frequent tension headaches or migraines, their headaches may be considered chronic. This could be due to medication overuse. Overuse of some OTC painkillers can actually cause headaches. It may be worthwhile to discuss the idea of a preventative medication instead of frequently treating headache pain with OTC painkillers.

If your child has four or more migraines a month that cause disability, such as missing school or other activities, this could be another reason to consider preventative management.

Prescription options include two classes of medications: abortive (used during an active migraine attack) and preventative (used to try and stop a migraine before it starts):

Abortives:

• Anti-nausea medications: Prescription-strength antiemetics like Zofran (ondansetron) can relieve nausea and vomiting, as well as other migraine symptoms, such as headaches and neck pain. For children, they are usually used during a migraine attack.
• Triptans: Triptans are potent prescription medications used for the treatment of moderate to severe migraine episodes. A few triptans, including Zomig (zolmitriptan) nasal spray, Axert (almotriptan), and Maxalt (rizatriptan), are approved for children. Your child's doctor will give you specific instructions regarding how much your child should take, when and how often the dose can be repeated, and when to call about side effects.

Preventatives:

• Cyproheptadine: An antihistamine, cyproheptadine has long been used as a preventative medication for childhood migraines. Because cyproheptadine can increase appetite (causing weight gain), prescribing is generally limited to younger children.
• Anti-CGRPs: Aimovig (erenumab), AJOVY (fremanezumab), and Emgality (galcanezumab) are part of a new class of preventative migraine medications taken in a monthly injection. Clinical trials with children and adolescents have yet to be completed. Recommendations from the Pediatric & Adolescent Headache special interest group of the American Headache Society suggest limiting the use of anti-CGRPs to post-pubescent adolescents until more data becomes available. They urge doctors to only choose anti-CGRPs for teens with severe chronic migraines that have not responded to other treatments.

Timing

Taking the medication right at the start of the symptoms is the best way to prevent a migraine attack from worsening. Your child may need to talk to the teacher and go to the school nurse if symptoms begin during school.

It is worthwhile for you to talk with your child about the various symptoms that occur with their migraines. Try to identify the earliest signs. Some children experience a prodromal stage before a migraine reaches its peak. Symptoms during the prodromal stage can include:

• Dizziness
• Stomach aches
• Photophobia (sensitivity to light)
• Phonophobia (sensitivity to sound)
• Osmophobia (sensitivity to smell)
• Irritability
• Sleepiness

Over time, your child can learn to recognize these and seek treatment as early as possible.

Avoiding Triggers

Medications can only do so much. Identifying and avoiding migraine triggers is an essential part of a complete migraine treatment and prevention plan.

Migraines can be triggered by a number of factors, including stress and lack of sleep. As a parent, you can work with your child to figure out if any of these factors cause your child's migraines—and how to avoid them.

Paying attention to these migraine triggers can often alleviate the need for medication in the first place. Common triggers include:

• Lack of sleep
• Skipping meals
• Stress and anxiety
• Excessive computer and electronic use
• Caffeine intake
• Dietary triggers

Unless you find a specific dietary migraine trigger, putting your child on a restrictive diet is not a good idea. Kids can be pretty picky about food, and unnecessarily eliminating foods "just in case" won't prevent migraines.

A Word From Verywell

Be sure to discuss your child's symptoms with their doctor before concluding that they are migraines. Some children have allergies, anxiety, or even medical problems that can manifest in the same way as migraines. Once migraines are diagnosed, you can focus on managing and preventing the episodes.

Talk to your pediatrician if your child's migraines worsen, change, or if your child develops new symptoms.